It lost ground in five areas. Minnesotans are fatter (slipping from 20th to 21st), don't graduate high school as often (the state was #1 in high school graduation in 1990 and has been slipping ever since -- down to #7 this year), have more fatalities at work, don't have health insurance (1st to 4th in state rankings), and don't get their children immunized at the rate the state once did.

Partly, perhaps, because of cuts in MinnesotaCare in recent years, the rate of uninsured in Minnesota is up from 7.9 percent to 9.2 percent. The percentage of Minnesotans in poverty is up to 11.1 percent. Vermont improved from 15th to 9th in this area, yet still trails Minnesota.

But it's the obesity that's killing the state. One of every four Minnesotans is obese. The prevalence of obesity increased from 10.2 percent in 1990 to 24.7 percent in the 2007 survey.

The survey also said African Americans in Minnesota are 63 percent more likely to die a premature death.

The report, called "A Call to Action," highlighted Minnesota's rate of binge drinking by teenagers. Even though the state improved its ranking from a year ago, Minnesota is still 41st. By contrast, Mississippi, the least-healthy state in the nation, is 4th.

Binge drinking appears to be a part of the Upper Midwest culture. Michigan, Minnesota, Nebraska, South Dakota, Illinois, Iowa, North Dakota, and Wisconsin make up 8 of the bottom 11 states in the category.

The report comes days after a 21-year-old woman became the latest binge-drinking death. Amanda Jax died last week in Mankato after a night of celebrating her 21st birthday.